Las Buenas Prácticas de Manipulación de Alimentos en el hospital

Tamara Díaz Lorenzo, Marta Cardona Gálvez

Texto completo:

PDF

Resumen

El hospital representa un caso particular de la restauración pública. En un hospital se preparan y se sirven grandes volúmenes de alimentos que se destinan primariamente a enfermos en los que concurren grados variables de inmunodepresión y desnutrición. La población hospitalaria se encuentra en riesgo incrementado de contraer una enfermedad transmitida por alimentos (ETA). Dadas las repercusiones de las ETAs para la gestión sanitaria y hospitalaria, se deben implementar sistemas de vigilancia epidemiológica de alcance institucional que produzcan información efectiva sobre el comportamiento local de estas entidades, como condición previa al reconocimiento y tratamiento de las mismas. Estos sistemas de vigilancia epidemiológica deben articularse con el diagnóstico de la situación sanitaria de la institución y la evaluación de los riesgos higiénico-sanitarios presentes en la misma. Deben existir pautas claras de actuación ante la ocurrencia de brotes de ETAs en el hospital que permitan identificar el(los) alimento(s) causantes y las personas afectadas, implementar el tratamiento médico y sanitario específico, e intervenir y corregir las no-conformidades | desviaciones detectadas en los procesos de  manipulación y elaboración de alimentos. La prevención de las ETAs implica la adopción de políticas institucionales de higiene personal y colectiva, limpieza y desinfección del utillaje culinario, las distintas áreas de elaboración y manipulación de alimentos, las superficies de contacto con los alimentos; y las manos del manipulador; y de control, tratamiento y prevención de las plagas y vectores. Las actividades de capacitación y educación continuada de los involucrados en la cadena alimentaria hospitalaria deben incorporarse en el diseño y gestión de los sistemas de garantía de la inocuidad y la seguridad alimentarias en la institución de salud a los fines de producir cambios perdurables en las formas en que los alimentos se manipulan y se preparan.

Palabras clave

Inocuidad; Enfermedades transmitidas por alimentos; Seguridad hospitalaria; Alimentación pública

Referencias

Newell DG, Koopmans M, Verhoef L, Duizer E, Aidara-Kane A, Sprong H; et al. Food-borne diseases- The challenges of 20 years ago still persist while new ones continue to emerge. Int J Food Microbiol 2010;139(Suppl):S3-S15.

Todd EC. Epidemiology of foodborne diseases: A worldwide review. World Health Statistics Quarterly 1996;50 (1-2):30-50.

Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL; et al. Foodborne illness acquired in the United States- Major pathogens. Emerg Infect Dis 2011;17:25-33.

Scallan E, Griffin PM, Angulo FJ, Tauxe RV, Hoekstra RM. Foodborne illness acquired in the United States- Unspecified agents. Emerg Infect Dis 2011;17:16-24.

Eurosurveillance Editorial Team. The European Union summary report on trends and sources of zoonoses, zoonotic agents and food-borne outbreaks in 2011 has been published. Euro Surveill 2013;18:20449.

Pires SM, Vieira AR, Perez E, Wong DLF, Hald T. Attributing human foodborne illness to food sources and water in Latin America and the Caribbean using data from outbreak investigations. Int J Food Microbiol 2012;152:129-38.

Prieto PA, Finley RL, Muchaal PK, Guerin MT, Isaacs S, Domínguez AC; et al. Burden of self-reported acute gastrointestinal illness in Cuba. J Health Populat Nutr 2009;27:345-53.

Carrera Vara JA, Márquez Rodríguez H, Castro Domínguez A, Mitidieri Jorge D. Análisis de las enfermedades trasmitidas por alimentos, 1980-1998. Rev Cubana Higiene Epidemiol 2000;38:167-74.

Grillo Rodríguez M, Fernández L, María E, Caballero Torres A, Castro Domínguez A, Hernández Alvarez AM. Análisis de las enfermedades transmitidas por los alimentos en Cuba. RCAN Rev Cubana Aliment Nutr 1996; 10:100-4.

Cross M, MacDonald B. Hospitals. En: Nutrition in Institutions. John Wiley & Sons. London: 2009. pp 103-216.

Rayner J. Hospital food: It’s enough to make you sick. Observer Food Monthly 2006;24.

Kipps M, Middleton V. Hospital catering. Nutrition Food Science 1990; 90:5-7.

Barreto Penié J, for the Cuban Group for the Study of Hospital Malnutrition. State of malnutrition in Cuban hospitals. Nutrition 2005;21:487–97.

Santana Porbén S. State of malnutrition in Cuban hospitals; a needed update. Nutrición Hospitalaria [España] 2015; 31:1900-9.

Scharff RL. Economic burden from health losses due to foodborne illness in the United States. J Food Protection 2012;75:123-31.

Díaz Lorenzo T, Cardona Gálvez M, Sánchez Azahares Y, Leyva Castillo V, Ferrer Márquez Y, Hernández I, Díaz Fernández JR. Riesgos higiénico sanitarios en la elaboración de alimentos en instalaciones hospitalarias. RCAN Rev Cubana Aliment Nutr 2013;23: 65-81.

Díaz Lorenzo T, Cardona Gálvez M, Vera Bueno F, Valcárcel Izquierdo N, Rodríguez Suárez A. Impacto de la implementación de un Manual de Buenas Prácticas de Manipulación de Alimentos en hospitales pediátricos. RCAN Rev Cubana Aliment Nutr 2013;23:235-46.

Santana Porbén S, Barreto Penié J. Grupos de Apoyo Nutricional en un entorno hospitalario. Tamaño, composición, relaciones, acciones. Nutrición Hospitalaria [España] 2007;22: 68-84.

Santana Porbén S, Barreto Penié J, Martínez González C, Espinosa Borrás A, Morales Hernández L. Grupos de Apoyo Nutricional en un entorno hospitalario. La experiencia cubana. Nutrición Hospitalaria [España] 2007;22: 425-35.

Gaynes RP. Surveillance of nosocomial infections. A fundamental ingredient for quality. Infection Control 1997:18:475-8.

Emori TG, Gaynes RP. An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev 1993;6:428-42.

Edmond MB, Wallace SE, McClish DK, Pfaller MA, Jones RN, Wenzel, RP. Nosocomial bloodstream infections in United States hospitals: A three-year analysis. Clin Infect Dis 1999;29:239-44.

Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB. Nosocomial bloodstream infections in US hospitals: Analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 2004;39:309-17.

Guanche Garcell H, Requejo Pino O, Rosenthal VD, Morales Pérez C, Delgado Gonzalez O, Fernández González D. Device-associated infection rates in adult intensive care units of Cuban university hospitals: International Nosocomial Infection Control Consortium (INICC) findings. Int J Infect Dis 2011;15:e357-e362.

Käferstein FK, Motarjemi Y, Bettcher DW. Foodborne disease control: A transnational challenge. Emerg Infect Dis 1997;3:503-10.

Martínez MMO. Enfermedades infecciosas transmitidas por alimentos. Rev Ciencias Médicas La Habana 2008;14:102-15.

McCabe-Sellers BJ, Beattie SE. Food safety: Emerging trends in foodborne illness surveillance and prevention. J Amer Diet Assoc 2004;104:1708-17.

Luning PA, Bango L, Kussaga J, Rovira J, Marcelis WJ. Comprehensive analysis and differentiated assessment of food safety control systems: A diagnostic instrument. Trends Food Sci Technol 2008; 19:522-34.

División de Prevención y Control de Enfermedades Transmisibles. Programa de Salud Pública y Veterinaria HPV/FOS. Guía para el establecimiento del sistema de vigilancia epidemiológica de enfermedades transmitidas por alimentos (VETA) y la investigación de brotes de toxi-infecciones alimentarias. Editorial ECIMED. La Habana: 2002.

Michaels B, Keller C, Blevins M, Paoli G, Ruthman T, Todd E, Griffith CJ. Prevention of food worker transmission of foodborne pathogens: Risk assessment and evaluation of effective hygiene intervention strategies. Food Service Technology 2004;4:31-49.

de Blackburn CW, McClure PJ. Food-borne pathogens: Hazards, risk analysis and control. Elsevier. London: 2009.

Bryan FL. Risks of practices, procedures and processes that lead to outbreaks of foodborne diseases. J Food Protection 1988;51:663-73.

Panisello PJ, Rooney R, Quantick PC, Stanwell-Smith R. Application of foodborne disease outbreak data in the development and maintenance of HACCP systems. Int J Food Microbiol 2000;59:221-34.

Guerrant RL, Van Gilder T, Steiner TS, Thielman NM, Slutsker L, Tauxe RV; et al. Practice guidelines for the management of infectious diarrhea. Clin Infect Dis 2001;32:331-51.

Greig JD, Todd EC, Bartleson CA, Michaels BS. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 1. Description of the problem, methods, and agents involved. J Food Protection 2007;70:1752-61.

Todd EC, Greig JD, Bartleson CA, Michaels BS. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 2. Description of outbreaks by size, severity, and settings. J Food Protection 2007;70:1975-93.

Todd EC, Greig JD, Bartleson CA, Michaels BS. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 3. Factors contributing to outbreaks and description of outbreak categories. J Food Protection 2007;70:2199-2217.

Todd EC, Greig JD, Bartleson CA, Michaels BS. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 4. Infective doses and pathogen carriage. J Food Protection 2008;71:2339-73.

Todd EC, Greig JD, Bartleson CA, Michaels BS. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 5. Sources of contamination and pathogen excretion from infected persons. J Food Protection 2008;71:2582-95.

Todd EC, Greig JD, Bartleson CA, Michaels BS. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 6. Transmission and survival of pathogens in the food processing and preparation environment. J Food Protection 2009;72:202-19.

Todd EC, Michaels BS, Greig JD, Smith D, Holah J, Bartleson CA. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 7. Barriers to reduce contamination of food by workers. J Food Protection 2010;73:1552-65.

Todd EC, Michaels BS, Greig JD, Smith D, Bartleson CA. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 8. Gloves as barriers to prevent contamination of food by workers. J Food Protection 2010;73:1762-73.

Todd EC, Michaels BS, Smith D, Greig JD, Bartleson CA. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 9. Washing and drying of hands to reduce microbial contamination. J Food Protection 2010;73:1937-55.

Todd EC, Michaels BS, Holah,J, Smith D, Greig JD, Bartleson CA. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 10. Alcohol-based antiseptics for hand disinfection and a comparison of their effectiveness with soaps. J Food Protection 2010;73: 2128-40.

Todd EC, Greig JD, Michaels BS, Bartleson CA, Smith D, Holah J. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 11. Use of antiseptics and sanitizers in community settings and issues of hand hygiene compliance in health care and food industries. J Food Protection 2010;73:2306-20.

Colectivo de autores. Guía para el estudio y vigilancia de las enfermedades transmitidas por alimentos. MINSAP Ministerio de Salud Pública. República de Cuba. La Habana: 2009.

Richards J, Parr E, Riseborough P. Hospital food hygiene: The application of Hazard Analysis Critical Control Points to conventional hospital catering. J Hospital Infection 1993;24:273-82.

Ehiri JE, Morris GP. Food safety control strategies: A critical review of traditional approaches. Int J Environm Health Res 1994;4:254-63.

Reglamento General de Hospitales. MINSAP Ministerio de Salud Pública. República de Cuba. La Habana: 2010.

Brackett RE. Shelf stability and safety of fresh produce as influenced by sanitation and disinfection. J Food Protection 1992; 55(10), 808-814.

Cozad A, Jones RD. Disinfection and the prevention of infectious disease. Am J Infect Control 2003;31:243-54.

Troller, JA. Sanitation in food processing. Academic Press. London: 2012.

Prüss A, Kay D, Fewtrell L, Bartram J. Estimating the burden of disease from water, sanitation, and hygiene at a global level. Environm Health Perspect 2002; 110:537-42.

Griffith CJ, Cooper RA, Gilmore J, Davies C, Lewis M. An evaluation of hospital cleaning regimes and standards. J Hospital Infection 2000;45:19-28.

Guerrero Pupo JC, Sánchez Fernández OA, Cañedo Andalia R. Vigilancia de la salud del trabajador: Un componente de la gerencia de las instituciones de la información. ACIMED 2004;12:1-5.

NC 143:2007. Principios Generales de Higiene de los Alimentos. Instituto Cubano de Normalización. La Habana: 2007.

NC 488:2009. Requisitos sanitarios de limpieza y desinfección de las instalaciones de alimentación colectiva. Instituto Cubano de Normalización. La Habana: 2009.

Malik RE, Cooper RA, Griffith CJ. Use of audit tools to evaluate the efficacy of cleaning systems in hospitals. Am J Infect Control 2003;31:181-7.

Powell DA, Jacob CJ, Chapman BJ. Enhancing food safety culture to reduce rates of foodborne illness. Food Control 2011;22:817-22.

Seaman P, Eves A. The management of food safety- The role of food hygiene training in the UK service sector. Int J Hospitality Manag 2006;25:278-96.

Seaman P. Food hygiene training: Introducing the food hygiene training model. Food Control 2010;21:381-7.

Acikel CH, Ogur R, Yaren H, Gocgeldi E, Ucar M, Kir T. The hygiene training of food handlers at a teaching hospital. Food Control 2008;19:186-90.

Rennie DM. Health education models and food hygiene education. J Royal Soc Promotion Health 1995;115:75-9.

Green LR, Selman C. Factors impacting food workers' and managers' safe food preparation practices: A qualitative study. Food Protection Trends 2005; 25:981-90.

Clayton DA, Griffith CJ, Price P, Peters, AC. Food handlers' beliefs and self-reported practices. Int J Environm Health Res 2002;12:25-39.

Green LR, Selman CA, Radke V, Ripley D, Mack JC, Reimann DW; et al. Food worker hand washing practices: An observation study. J Food Protection 2006;69:2417-23.

Medeiros CO, Cavalli SB, Salay E, Proença RPC. Assessment of the methodological strategies adopted by food safety training programmes for food service workers: A systematic review. Food Control 2011;22:1136-44.

Ehiri JE, Morris GP. Hygiene training and education of food handlers: Does it work? Ecology Food Nutrition 1996;35: 243-51.

Enlaces refback

  • No hay ningún enlace refback.